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Recent HIPAA Breach Settlements - Lessons Learned

Client Alert

As a healthcare provider, you are likely familiar with the Health Insurance Portability and Accountability Act (HIPAA). But, do you know how serious the consequences could be for a breach of HIPAA? According to the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR), the consequences for providers may include settlements of $30,000 to $240,000. OCR recently released two settlements for improper breaches of protected health information (PHI) that are good examples of the major monetary penalties that can result from common HIPAA mistakes.

Disclosing PHI in Responses to Negative Reviews

In April 2020, a health care provider in New Jersey impermissibly disclosed the PHI (including information on diagnoses and treatment) of its patients in response to negative online reviews. OCR investigated following a complaint from the patient and found that the provider impermissibly disclosed patient PHI and failed to implement policies and procedures with respect to protected information. On June 5, 2023, the provider agreed to pay $30,000 to OCR to settle the complaint. Additionally, the provider agreed to implement a corrective action plan to resolve potential violations. The plan included a few of the following steps:

  • Train all members on the organization’s policies and procedures to comply with HIPAA Privacy;
  • Issue breach notices to all whose PHI was disclosed on any internet platform without valid authorization; and
  • Submit a breach report to HHS on individuals whose PHI was disclosed on any internet platform without valid authorization.

In response to the complaints, OCR Director Melanie Fontes Rainer stated, “OCR continues to receive complaints about health care providers disclosing their patients’ protected health information on social media or on the internet in response to negative reviews.” They added, “[s]imply put, this is not allowed.”

Snooping by Security Guards

On June 15, 2023, a Washington hospital paid $240,000 to settle its HIPAA breach affecting 419 individuals. Following a breach notification report filed by the hospital, OCR investigated and found that 23 of the hospital’s security guards impermissibly accessed the medical records of hundreds of patients without a job-related purpose. The guards accessed information including names, dates of birth, medical record numbers, addresses, certain notes related to the treatment, and insurance information.

In addition to a $240,000 settlement, the hospital was required to implement a plan to update its policies and procedures to safeguard PHI and prevent its workforce members from snooping in the future. Further, the hospital was to be monitored for two years by the OCR to ensure its compliance with the HIPAA Security Rule. The hospital agreed to take the following steps, among others, to bring it into HIPAA compliance:

  • Conduct a risk analysis to determine risks and vulnerabilities to electronic PHI;
  • Develop and implement a risk management plan to address and mitigate identified security risks and vulnerabilities identified in the risk analysis; and
  • Enhance its existing HIPAA and Security Training Program to provide workforce training on updated HIPAA policies and procedures.

“Data breaches caused by current and former workforce members impermissibly accessing patient records are a recurring issue across the healthcare industry. Healthcare organizations must ensure that workforce members can only access the patient information needed to do their jobs,” Fontes Rainer stated. “HIPAA covered entities must have robust policies and procedures in place to ensure patient health information is protected from identity theft and fraud.”

HIPAA breaches are to be taken very seriously. It is imperative for health care providers to have current HIPAA compliance plans, trainings, and breach protocols. For questions, or to update your HIPAA compliance plan, please reach out to attorney Ashley Watson at abwatson@bmdllc.com or any members of the BMD Healthcare Team.


The Ohio Board of Pharmacy’s Latest Batch of Rules: What Providers Should Know

The Ohio Board of Pharmacy released several new rules and proposed amendments to existing rules over the past month that will significantly impact pharmacy operations. Topics range from updates to the Terminal Distributor of Dangerous Drugs license to mobile clinics to mandatory rest breaks for pharmacists of outpatient pharmacies. A summary of the proposed changes is below, along with instructions for commenting on the rules. Your BMD healthcare attorney can help write comment letters and submit the comments on your behalf as well.

Employee or Independent Contractor? New Guidance Issued by the Department of Labor

On January 9, 2024, the U.S. Department of Labor (DOL) issued its long-awaited final rule — effective March 11, 2024 — revising its prior interpretation of worker classifications under the federal Fair Labor Standards Act (FLSA). The new final rule rescinds the standard previously established in 2021, in turn, shifting the analysis of whether a worker is an employee (versus an independent contractor) of a business from a more streamlined “economic reality” test to a more complex “totality of the circumstances” standard.

Increased Medicaid Rates to Take Effect This Month for Ohio Providers

As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024.

Corporate Transparency Act Update

The Corporate Transparency Act (“CTA”), with an effective date of January 1, 2024, is set to impose strict reporting guidelines on business owners throughout the country. The following provides a brief update on two aspects of the CTA ahead of its effectiveness next week.

The Second Wave of UnitedHealthcare's Prior Authorization Cuts Started in November

In August 2023, UnitedHealthcare released its plan to eliminate roughly one-fifth of its then-current prior authorization requirements. The first round of prior authorization cuts took effect on September 1, 2023. In that round, UnitedHealthcare eliminated the necessity for some prior authorizations for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plan members. The second and final round of prior authorization cuts began on November 1, 2023. The November 2023 Prior Authorization Cuts apply to the same plans as well as community plans (i.e., Medicaid managed care plans).